Bipolar disorder is not a specific diagnosis. Rather, it covers a spectrum of mood disorders. It is on that basis that I state that it is not A mental disorder. Rather, it is collection of specific independent diagnoses which, grouped together, are referred to as the bipolar spectrum. This collection of mental disorders are considered to be amongst the hardest mental disorders to accurately diagnose.
There are a number of factors which make diagnosing it as being from within the bipolar spectrum difficult. If that is correctly achieved there can be further difficulty in specifying exactly which type of specific disorder is present. An accurate diagnosis makes a successful treatment far easier to achieve.
Manic depressive disorder, now more commonly known as bipolar disorder, can have a devastating effect on the life of anyone afflicted with it. It can take complete control of that person’s life. This occurs as the afflicted person experiences mad manic episodes or one of those major depressive episodes. This type of bipolar is known as bipolar, type 1. Many people consider this the worst possible specific diagnosis of the disorder one can get. Not only that, it can severely affect the life of friends and loved ones of anyone so afflicted. Even when “normal” friends, loved ones and the afflicted person can be living in fear of when the next episode will occur.
As is often the case with depression it can lead to attempted suicide or even suicide. There are a number of websites on the internet which quote that one person out of two diagnosed with bipolar disorder will attempt suicide at some stage in their life. Worse still, the statistics indicate that one in twenty persons with the disorder will succeed. Statistics also indicate that if a good treatment regime is in place the risk of attempted or successful suicide is greatly reduced.
If you fear that a friend or loved one with bipolar disorder might be considering suicide seek help urgently. There are many avenues available. A good starting point could be afflicted person’s health professional. This is such an important topic that I will be devoting an entire article to it in the near future.
Next down is a diagnosis of bipolar type 2. Here the manic episodes do not normally occur. Instead a hypomanic episode is experienced. These can result in:
1) Happy, excited and joyful feelings
2) Talking more, faster and often louder
3) Increased energy, more activity and an inability to sit still
4) Increased sexual drive
5) Irritability and
6) Recklessness leading to poor decision-making.
The poor decision-making often relates to sexual or money matters. They are often of a very serious nature. They can lead to relationship breakdowns. Conversely hypomania can have an extremely important part to play in the successful treatment of bipolar disorder.
The next level down in a bipolar disorder diagnosis is cyclothymic disorder. With this type the highs and the lows are not as pronounced as with bipolar types 1 and 2. This might sound good. However, it does have a distinct potential disadvantage. This type can be extremely difficult to diagnose. The mood-swings can, and do, escape the notice of even the best health professionals. This is especially the case were there is a reasonably long period of normal moods between the change of mood. The potential disadvantage here is the possibility that the cyclothymic disorder may not be picked up. This leaves the afflicted person experiencing greater than normal mood-swings without treatment.
Up to now I have discussed the spectrum of bipolar disorders in terms of the levels of their highs and lows. The spectrum also includes diagnoses which take into account the frequency of the highs and the lows. The first of these is rapid cycling bipolar disorder. This diagnosis applies where the afflicted person experiences four or more episodes within a one year period. It is not unknown for two or even more episodes to occur within a twenty-four hour period. The reducing time between highs and lows can come into effect with the passage of time if the patient is not receiving satisfactory treatment for the disorder.
Another diagnosis is mixed bipolar disorder. This diagnosis applies when the afflicted person experiences the symptoms of highs and lows at the same time. Once again the conflicting, and confusing, symptoms can, and do, lead to difficulties in diagnosing mixed bipolar disorder.
Bipolar is considered to be one of the most difficult mental groupings to diagnose accurately. The first problem is the fact that it covers the two extremes of the mental health spectrum, mania and depression. The next complication is the variation in time between different patients experiencing their personal highs and lows. Also, different patients can and do cycle in a different direction. Most cycle hypomania first, (then mania if bipolar type 1), then depression. However, a number do cycle in the reverse order
All these variations in the bipolar spectrum of mood disorder do combine to make its diagnosis extremely difficult. This difficulty can lead to further difficulty in setting up a successful treatment regime for the disorder. It is common for afflicted patients to only seek treatment for depression. This can leave the health professional totally unaware of the “high” side of the disorder. The diagnosis must then be wrong because it is based on inaccurate (incomplete) information.
A complete and accurate diagnosis makes the prescription of a successful treatment regime far easier to achieve. The key to correct diagnosis is total, and accurate, communication between patient and doctor. Can you see a pattern forming here which could lead to a successful treatment for bipolar disorder?